Credit Account Closure Dispute Form
Credit Account Closure Dispute Form
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Last 4 Digits of Account Number
*
Date of Account Closure
*
-
Month
-
Day
Year
Date
How were you notified about the account closure?
*
Email
Phone Call
Letter
Online Banking Notification
Other
Reason for Dispute
*
Please Select
Account closed in error
No prior notice received
Outstanding balance issue
Disagreement with closure reason
Other
Please describe the circumstances and provide supporting facts for your dispute
*
Preferred Resolution
*
Upload Supporting Documents (if any)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Submit
Should be Empty: